Q Initiation and advancement of enteral nutrition (EN) are often delayed clinically because of the use of “high-dose” vasopressors. Are there standards for high-dose vasopressors? Does their use require delaying either initiation or advancement of EN?

A Jan Powers, PhD, RN, CCNS, CCRN, NE-BC, replies:

This question is a relevant one that many have struggled with for decades. Enteral nutrition (EN) has many positive benefits in critically ill patients, and early initiation of EN leads to fewer complications and improved patient outcomes. Just a few of the benefits of EN include improved wound healing, less loss of lean muscle mass, and maintenance of structural and functional gut integrity, which helps to bolster immunity and reduce infection. Even consuming only 20% of nutrition via EN can provide to a patient protective functions through innate immunity, for example, by attenuating the loss of function of the gut barrier.

Even with the...

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